NPI | 1588076715 |
---|---|
Former Name | AMANDA ELIZABETH RAGO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 274736) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ME DO2666) |
Enumeration Date | 2014-05-22 |
Last Update Date | 2019-06-18 |